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At least 271 records · Page 15Linked to original sources
PubMed1975

Massive periretinal proliferation (MPP) IV. Pre- and subretinal proliferation of glial tissue in experimental retinal detachment.

In experimental retinal detachment of the owl monkey eye, the formation of pre- and subretinal membranes was observed which typically had cellular connections to the retina proper. Based on light microscopic findings, it could be concluded that retinal cells grew out of the retina and built up the pre- and subretinal tissue. Electron microscopically these cells are glial cells (astrocytes) which grow out of the retina through focal interruptions in the internal limiting membrane and external limiting membrane. In the immediate area of outgrowth, Mueller cell processes participate in the formation of pre- and subretinal tissue.

Animals↗
PubMed1984

Experimental retinal detachment. V. Fluid movement through the retinal hole.

Unilateral chronic rhegmatogenous retinal detachments were produced in eight cynomolgus monkeys. Fellow eyes underwent total vitrectomy. Aqueous-plasma and vitreous-plasma ratios of fluorescein isothiocyanate-dextran (70,000 molecular weight) after intravenous administration were less than 0.004 in detached and fellow eyes. Intravitreal injection of fluorescein isothiocyanate-dextran in detached eyes passed into the subretinal space at a rate of 1.12 microL/min, where it was visibly sequestered for months. In fellow eyes, fluorescein isothiocyanate-dextran moved slowly from the vitreous cavity into the anterior chamber. The aqueous flow through the anterior chamber was lower in detached eyes. It is concluded that in eyes with rhegmatogenous retinal detachment, a flow of fluid exits from the posterior chamber, through the vitreous humor and retinal hole, into the subretinal space, and across the retinal pigment epithelium.

Animals↗
PubMed2004

Massive retinal gliosis: a late complication of retinal detachment surgery.

PURPOSE: Massive retinal gliosis is a rare, benign, intraocular tumor. It develops mostly in long-standing ocular disease such as chronic inflammation, vascular disorders, glaucoma, trauma, or congenital abnormalities. We report on a case of massive retinal gliosis, which developed 17 years following retinal detachment surgery. METHODS: Case report. RESULTS: A 64-year-old woman developed a peripheral fundus tumor 17 years after successful retinal detachment surgery. Follow-up examination demonstrated growth of the mass. The tumor was treated by pars plana vitrectomy and local endoresection. Histopathological study revealed massive reactive gliosis of the retina. CONCLUSIONS: To our knowledge, this is the first histopathologically proven case of a massive retinal gliosis, which developed after a non-drainage retinal detachment surgery. Endoresection is a therapeutic option in suspected massive retinal gliosis. It provides material for histological diagnosis which obviates unnecessary intervention in a functioning eye.

Catheterization↗
PubMed1995

Prophylaxis of retinal detachment.

Prophylactic treatment of retinal breaks can only be justified if the risk of complications from treatment is lower than the risk of breaks leading to clinical retinal detachment. Recommendations for prophylaxis should be based on results from valid controlled studies and not merely on traditional high-risk associations between certain risk factors and clinical retinal detachment. Present evidence supports prophylactic treatment of all symptomatic tractional tears; and is suggestive for the treatment of large, symptomatic operculated tears, high-risk fellow eyes of nontraumatic giant retinal breaks, retinal breaks with subclinical retinal detachments threatening progression, and retinal breaks before cataract surgery. Support for prophylactic treatment of asymptomatic retinal breaks in aphakic and pseudophakic eyes with or without an intact posterior capsule is at best, equivocal. Asymptomatic retinal breaks in phakic eyes with lattice degeneration, high myopia, and fellow eye detachments show no significant benefit from prophylaxis and should be followed without treatment.

Eye Diseases↗
PubMed1980

Recovery from macular photostress and slow retinal potentials in cured retinal detachment.

After successful surgery for retinal detachment, a series of functional tests was performed, which primarily concerned the contact between photoreceptors and pigment epithelium. Even several months after reattachment the EOG still remained lower than in the fellow eye, when the macula was involved. If maximal visual acuity was reached with a formerly detached retinal area, the photostress recovery time was found to be delayed. The dc-coupled ERG showed distinct impairment of the c-wave in the eye with the reattached retina.

Electrooculography↗
PubMedDate not supplied

Retinal angiomatous mass. A complication of retinal detachment surgery.

Retinal angiomatous masses were observed as a very late complication in four patients following scleral buckling procedures with drainage of subretinal fluid. The lesions manifested 5-19 years after the original surgical procedure, and the presenting complaint was decreased vision secondary to vitreous clouding. In three patients a vascularized retinal mass greater than 3 disc diameters in size was observed at the site of choroidal perforation for drainage of subretinal fluid. A fourth patient demonstrated a similar lesion in the location of a suture used to anchor the encircling element, possibly the point of accidental choroidal perforation. Three of the four patients were treated by photocoagulation or cryocoagulation with cicatrization of the angiomatous mass and obliteration of the vascular net. This resulted in clearing of vitreous opacities and subretinal exudates, with restoration of vision to a level prior to the onset of symptoms.

Adult↗
PubMed1990

Three-dimensional analysis of averaged electroretinograms for the evaluation of rhegmatogenous retinal detachment and related pathological conditions.

Retinal functional imaging in patients with rhegmatogenous retinal detachment and related pathological conditions was undertaken in 62 eyes of 44 cases by means of three-dimensional analysis (X-Y plane and time) of electroretinogram (ERG) topography. The analysis revealed that the area of maximal amplitude in both dominantly photopic and scotopic conditions deviated to the skin area closest to the location of the retinal detachment (hereafter referred to as paradoxical localization). In temporal retinal detachment, for example, the location of the maximal amplitude of the a- and b-waves deviated toward the temporal side on surface topography. Flicker ERG with a stimulus frequency of 30 Hz was especially successful for disclosing the existence and the location of posterior involvement of retinal detachment within the area surrounding the temporal vascular arcades. The mechanisms of paradoxical localization were considered to be changes in the axis of the equivalent dipole in detachment eyes. These abnormalities disappeared after the retina was reattached. Although the buckling procedure and argon laser retinopexy had little effect on the topographical distribution of the a- and b-waves, it was markedly distorted by cryoretinopexy. No remarkable changes in the topographical distribution of the waves were detected in pathological conditions predisposing to rhegmatogenous retinal detachment. This new method for functional imaging of the retina promises to be valuable for objective clinical evaluation of retinal detachment.

Adult↗
PubMed1997

Ultrasound biomicroscopic view of detachment of the ciliary epithelium in retinal detachment with atopic dermatitis.

PURPOSE: The authors evaluated the effectiveness of ultrasound biomicroscopy to determine the condition of the ciliary body during perioperative examinations of patients with atopic dermatitis and retinal detachment. METHODS: The authors compared two groups of patients with atopic dermatitis and retinal detachment. Parameters included patient age, gender, eye, cataract, type and location of breaks, macular involvement, detachment of the ciliary epithelium, and preoperative and postoperative best-corrected visual acuities. Group 1 included six patients (nine eyes) who were examined before surgery and after surgery using ultrasound biomicroscopy, with which the authors also measured the maximum height of the detachment of the ciliary epithelium. Group 2 included 10 patients (13 eyes) who did not undergo ultrasound biomicroscopy. RESULTS: In group 1, ultrasound biomicroscopy showed ciliary epithelium detachment in all eyes before surgery and in eight of nine eyes after successful retinal reattachment. The height of the ciliary detachment, however, decreased dramatically after surgery. Although almost all the parameters between groups 1 and 2 were similar, the authors observed a significant difference in the incidence of preoperative diagnosis of ciliary detachment (P = 0.023). CONCLUSION: Ultrasound biomicroscopy is beneficial in detecting detachment of the ciliary epithelium. The residual shallow detachment that remains after successful surgery suggests the fragility of the ciliary body.

Adolescent↗
PubMedDate not supplied

Morphological recovery in the reattached retina of the toad Bufo marinus: a new experimental model of retinal detachment.

BACKGROUND: The retinal pigment epithelium (RPE) of the toad (Bufo marinus) has been used in many studies as a model for understanding its role and interaction with the neural retina. The toad's retina has been used to establish a new in vitro model of experimental retinal detachment (RD) and replacement . It has been shown that the electrophysiological measures of retinal function recovered following complete RD. The toad was chosen because its RPE is similar to the mammalian RPE . In this report, light microscopy was used to characterize the morphologic changes that occur in the RPE and neural retina following RD/replacement and to correlate these findings with recovery of electrophysiologic function. METHODS: Retinas from Bufo marinus were studied in vitro. The neural retina completely detached from the RPE and then replaced. At various times after replacement, neural retina-RPE tissues were processed for light microscopy. RESULTS: At 30 min after replacement, the subretinal space was greatly expanded, and the apical processes that normally ensheath the rod outer segments were short and no longer contacted the rod outer segments. The RPE was swollen, contained many vacuoles and the apical surface was rounded. By 2 h after replacement, the subretinal space was significantly resorbed and contained many shredded rod outer segments; RPE cells were still swollen, although less. During the next 5-10 h, the number of phagosomes in the RPE cytoplasm increased and the number of shredded rod outer segments in the subretinal space decreased. RPE cells regained their normal size and interdigitation of apical processes and rod outer segments were observed. CONCLUSIONS: These results demonstrate the re-establishment of morphological interactions between the RPE and neural retina within hours following RD/replacement. Morphological recovery coincides with recovery of electrophysiologic parameters. This is a good model to investigate the retinal pigment epithelium (RPE) and neural retina mechanisms involved in retinal adhesion and recovery from retinal detachment.

Animals↗
PubMed2000

[Current status of retinal detachment in AIDS patients].

Cytomegalovirus retinitis is the most common opportunistic ocular infection in patients with AIDS affecting 30 to 40% of the patients. It usually occurs in patients in the terminal stage of the disease presenting with low CD4+ count (<50/mm(3)). Retinal detachment (RD) is a frequent complication of this disease, with an incidence varying from 18% to 29%. Risk factors for development of rhegmatogenous RD in patients with CMV retinitis were peripheral involvement greater than 25%, the presence of active retinitis, greater patient age and lower CD4+ cell counts. Multiple or single holes, as well as micro holes, were observed in areas of retinal necrosis leading to complex retinal detachments. Strong vitreoretinal adherences in these young patients, associated with chronic inflammation, were important elements in the pathophysiology of retinal detachment in AIDS patients. For localized RD, demarcating laser photocoagulation may delayed or avoided vitreoretinal surgery. For RD with macula off, good anatomical results have been obtained by repairing CMV retinitis-related retinal detachments using primary vitrectomy and instillation of silicone oil. Despite good anatomical results, poor long term functional results are related to optic atrophy. Since the introduction of highly active antiretroviral therapy (HAART), retinal detachment incidence has nevertheless dramatically decreased. Under HAART, CMV retinitis remains quiescent for long periods of time with a reduction of retinal detachment incidence of approximately 77%. For some patients on HAART, retinal reattachment can be obtained using vitrectomy, posterior hyaloid removal, and intraocular tamponade with SF-6 gas.

AIDS-Related Opportunistic Infections↗
PubMed1992

Clinicolegal aspects of vitreous and retinal detachment.

Failure to diagnose retinal detachment is an important cause of professional liability claims involving optometrists. To comply with medical standards, dilation of the pupil and examination of the retinal periphery are required, both for patients who are at risk for retinal detachment and for patients who are symptomatic. Important risk factors include a history of previous detachment, myopia, lattice retinal degeneration, aphakia and pseudophakia, YAG capsulotomy, treatment of primary open-angle glaucoma with miotic drugs, blunt ocular trauma, and the proliferative retinopathies. Patients with the symptoms of acute posterior vitreous detachment must receive a dilated fundus examination, evaluation of the retinal periphery, and assessment of the vitreous. If examination results are negative, the patient should be warned of the symptoms of retinal detachment and scheduled for reevaluation in 4 to 8 weeks. Examination findings, warnings, recall appointments, and referral for treatment should be documented in the patient's record of care.

Diagnostic Errors↗
PubMed1988

[Development of traumatic retinal detachment].

Post-traumatic retinal detachment occurs frequently as a late consequence of progressive vitreous changes, especially following penetrating injuries. Occasionally, it develops soon after the trauma, without preceding proliferative vitreoretinopathy, is based on posterior vitreous detachment and morphologically resembles an idiopathic retinal detachment. It is possible that the posterior vitreous detachment in these cases is encouraged by the presence of intravitreal hemorrhage.

Adolescent↗
PubMed1992

Prediction of visual recovery after scleral buckling of macula-off retinal detachments.

Patients with rhegmatogenous retinal detachments involving the fovea have visual loss that may not be recoverable despite anatomically successful surgery. Few guidelines exist to predict ultimate visual outcome with any certainty. We found that despite macular detachment, a device commonly used to predict visual acuity in cataractous eyes, the Potential Acuity Meter (Mentor O & O, Inc., Norwell, Massachusetts), provided acuity measurements even when Snellen visual acuity levels were poor or unmeasurable. In a study of 50 consecutive patients with clear media, we investigated a possible correlation between postoperative Snellen visual acuity with the preoperative Potential Acuity Meter results. We found that actual visual improvement correlated well with potential visual improvement as determined by Potential Acuity Meter measurements (R = .92). Preoperative assessment of patients with this device was a better predictor of final visual outcome than preoperative Snellen visual acuity, the extent of retinal detachment, or the duration of the retinal detachment by history.

Adult↗
PubMed2004

The fellow eye of patients with phakic rhegmatogenous retinal detachment from atrophic holes of lattice degeneration without posterior vitreous detachment.

BACKGROUND: Primary phakic rhegmatogenous retinal detachment (RRD) without posterior vitreous detachment (PVD) represents a unique clinical entity that behaves differently from RRD associated with PVD. While previous studies have reported the long term findings in the fellow eye of patients with RRD and PVD, the outcome of the fellow eye of patients with RRD without PVD is not known. METHODS: Consecutive patients with RRD not associated with PVD were studied retrospectively. The authors evaluated the fellow eye for retinal detachment or other vision threatening pathology. RESULTS: 27 patients (mean age 32 years) were studied with follow up of between 9 and 326 months (mean 111 months). 24 (89%) were myopic. Bilateral retinal detachment occurred in eight patients (30%). On initial examination, 17 patients (63%) had retinal findings (including lattice degeneration, atrophic holes, and/or cystic retinal tufts) in the fellow eye that might predispose them to retinal detachment. 14 vision threatening events or diagnoses occurred (nine of which were rhegmatogenous in nature) in the fellow eye including eight retinal detachments, one traumatic PVD without retinal tears, one retinal tear after PVD, one diagnosis of pigmentary glaucoma needing trabeculectomy, two visually significant cataracts, and one diagnosis of chorioretinitis. 23 patients (85%) maintained visual acuity better than 20/50, with most retaining 20/20 vision in the fellow eye. CONCLUSIONS: Patients who experience RRD without PVD are at risk of developing vision threatening events in the contralateral eye and, as such, the fellow eye should be followed carefully.

Adolescent↗
PubMed1991

Exudative retinal detachment after photodynamic injury.

Exudative retinal detachments occur in a variety of retinal and choroidal diseases. We created serous retinal detachment in the cat eye by means of photodynamic injury produced by activation of intravascular rose bengal using filtered, focused light (550 nm). Fluorescein angiography later revealed focal retinal and choroidal vascular occlusion surrounded by a larger area of leakage through the pigment epithelium. Serous retinal detachments occurred rapidly, gradually enlarged over the next 3 days, and resolved in all eyes after 14 to 21 days. Histopathologic and ultrastructural features of early lesions included the accumulation of proteinaceous fluid in the subretinal space, pigment epithelial cell damage, and localized occlusion of retinal vessels and the choriocapillaris. Later changes consisted of limited regeneration of the retina and portions of the tapetum. In several respects, these experimental detachments resemble the serous retinal detachments associated with choroidal ischemia in humans, and may serve as a useful model in the study of choroidal microvascular hypoperfusion.

Animals↗
PubMed2006

Tent-shaped retinal detachments in retinopathy of prematurity.

BACKGROUND: Most retinal detachments associated with retinopathy of prematurity (ROP) are radial, segmental, or circumferential with cicatricial extraretinal fibrovascular proliferation (EFP) at the apex of the detachment. This report describes peculiar tent-shaped retinal detachments that developed among eyes with ROP. METHODS: An observational case series consisting of 9 patients and 13 eyes with tent-shaped retinal detachments. Their morphology, clinical baseline, surgical course, and final retinal status were extracted from medical records. RESULTS: Eight had simple tent-shaped retinal detachments, three had a double tent-shaped retinal detachment, one had a chevron-based retinal detachment, and one had a star-shaped retinal detachment. Each case had a disk based stalk that extended to the apex of the traction retinal detachment and continued anteriorly; 12 stalks inserted in the retrolental space and 1 terminated in the mid vitreous. Six eyes were stage 4A, two eyes were stage 4B, and five eyes were stage 5. Vitrectomy surgery was performed on 11 eyes. Surgery resulted in retinal attachment in nine eyes, and two retinas remained detached. CONCLUSION: Tent-shaped retinal detachments are seen in patients with ROP. A stalk should be sought in evaluation of these eyes. Vitreous surgery focused on relieving this traction is often successful.

Diagnosis, Differential↗